Pregnancy in Postural Orthostatic Tachycardia Syndrome

Abstract

In long-term follow-up, both women reported improvement in their prepartum symptoms. We describe the first report, to our knowledge, of two successful pregnancy outcomes in severe POTS, including the first report of midodrine use in pregnant women.

Anaesthesia for caesarean section in a patient with Ehlers-Danlos syndrome associated with postural orthostatic tachycardia syndrome

“…7,8 Fluid preloading has been used before establishing the block. Our patient had no obvious contraindication to regional anaesthesia, but Ehlers-Danlos syndrome may be associated with bleeding disorders.…”

“…Four cases of pregnancy in women with POTS have been described. [6][7][8] In all cases epidural analgesia or anaesthesia was used but full details of anaesthetic management are available in only two of the cases. To our knowledge there is no previous report of anaesthetic management for delivery in hypermobility type Ehlers-Danlos syndrome associated with POTS.…”

Postural orthostatic tachycardia syndrome complicating pregnancy: a case report with review of literature

“…Exercise training and re-conditioning is emerging as a very important strategy. In a study by Glatter et al 7 lifting the baby and caring for the infant forced women to develop their upper body strength that attributed to the improvement in symptoms as well as a positive psychological outlook at six months postpartum. Treatments must be carefully tested due to medication sensitivity often associated with POTS patients, and each patient will respond to different therapies in different ways.…”

“…Beta blockers are used to treat adrenergic symptoms. 5 Glatter et al 7 was the first to describe the use of midodrine, a category C drug, in pregnancy in his patients. A study by Powless et al showed that the patients who did not require treatment for POTS prior to conception remained so with a less likely chance of exacerbation.…”

“…Glatter et al 7 was the first to report pregnancy in POTS patients and as the patients worsened after six months' pregnancy, elective caesarean section was performed to attenuate the stress of labour and avoid consequent triggering of a tachycardic response. But, subsequently published studies have shown that vaginal delivery with adequate labour analgesia is safe in these patients and caesarean section should be reserved for obstetric indications.…”